Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04485 | Date 14/06/2021 |
| Token No | SM/21-22/417 14/06/2021 | Serial | 015 |
| Patient Name | Mrs. RINKU TANTI | Contact No | 8961123128 |
| Address | 100 ER B SARANI | Age | 27 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||